Abstract: Secondary orbital melanoma is a common type of orbital melanoma and has complicated origins. The most common primary tumor is choroidal melanoma, followed by conjunctival melanoma and cutaneous melanoma, and rarely caused by eyelid and paranasal sinus melanoma. According to the difference of primary tumor, the symptoms and signs manifest various, such as proptosis, diplopia, visual damage and pain. Diagnosis of this disease tend to be difficult. It is spiny and vital to be distinguish from primary orbital melanoma. Histopathological examination can help clinicians gain the diagnosis of melanoma, CT and MRI show the primary focus. Surgery is the main treatment, and adjuvant radiotherapy and chemotherapy should be considered. At present, immunotherapy has shown promising prospects in the theatment of secondary orbital melanoma caused by distant metastasis. As a kind of highly malignant tumor, prognosis of this disease is difficult to predict because of its perplexing origins as early as possible. (Int Rev Ophthalmol, 2022, 46: 91-96)

Key words: orbital, melanoma/ secondary